What should someone with a CVA do to prevent contractures?

• A. Keep joints fully extended without bends
• B. Keep joints flexed at all times
• C. Move joints only when necessary
• D. Avoid any joint movement

Answer: (A)

Contractures develop when soft tissues shorten because a joint isn’t moved regularly. After a CVA, keeping the affected limb in a position that preserves length and flexibility of muscles and connective tissue is key. Maintaining joints in extension and providing regular range-of-motion movement helps prevent shortening of muscles and tendons, preserves joint alignment, and reduces the risk of fixed bending in the future. Active movement is ideal, but when the patient can’t move on their own, assisted passive range of motion should be done consistently to keep joints from becoming stiff.

Keeping joints flexed at all times would promote shortening of flexor muscles and lead toward contractures. Moving joints only when necessary allows the tissues to tighten over time, and avoiding movement altogether leads to rapid contracture development.